Migraine Journals and Digital Health: Introduction

Migraine is one of the most common neurological disorders, which can lead to severe disability and poor quality of life. Migraine journals and diaries, however, can help professionals and patients monitor the severity, duration, and frequency of patients’ migraine attacks in order to identify triggers and improve treatments.

In an era where digital technology applies to numerous healthcare settings, mHealth apps and online platforms can only improve headache treatments and patients’ quality of life. Online migraine journals can enhance doctor-patient communication and benefit research and practice.

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Introduction

Experiencing pain and headaches, in particular, is a global health concern. Migraines are defined as the number one cause of neurological disability. With more than 1 billion people suffering from migraine, migraine is among the ten most prevalent health conditions, as stated by the World Health Organization. Headaches can be accompanied by different health complications, such as nausea, vomiting, sleep disorders, and memory problems; and they can lead to numerous negative emotional and social consequences.

Understanding symptoms and triggers can improve health outcomes, so migraine journals can only benefit patients and practitioners. In fact, the first step towards better management and treatment is keeping a headache journal. A migraine diary can help people:

  • Monitor pain severity and quality: Since there are different types of pain (e.g., piercing sensations), pain severity and quality must be evaluated accurately.
  • Assess pain frequency and duration: Tracking pain frequency and duration can help doctors treat migraines effectively and support insurance claims.
  • Locate where exactly the pain is: Pain location is an essential factor as pain can spread over the body and impact different bodily functions.
  • Identity triggers (e.g., menstrual cycle in women) and patterns: Since there’s no permanent cure for migraines, understanding triggers and patterns is a must to help patients manage and prevent migraine attacks.
  • Track migraine medication and effectiveness: As there’s a wide variety of drugs on the market, migraine medication and effectiveness must be assessed carefully. Note that prolonged use of pain relievers can lead to other health issues, such as gastrointestinal problems or substance abuse.
  • Assess behavioral changes and health outcomes: When it comes to behavioral changes, quality of life should be a focus of research, especially in chronic and reoccurring conditions.
  • Monitor lifestyle, work, and social outcomes: Headaches are complex phenomena. Therefore, maintaining records of vital factors, such as sleep, exercise, food, weather, etc., is essential. Note that information collected 6-8 hours prior to the migraine attack is vital. Thus, electronic advancements can give patients the chance to enter and share data with their physicians in real time, 24/7.
  • Improve doctor-patient communication and benefits research: Digital migraine journals have numerous benefits, which can lead to better healthcare practices. By providing accurate data in real time, patients can contribute to the better understanding and management of the disease. Effective evaluation, management, and communication can foster research and clinical trials. Digital solutions, in particular, can facilitate not only research but medical practices worldwide.

Migraine Monitoring and Digital Solutions

Migraines are a global health burden. Since migraine attacks lead to numerous physical, emotional, and financial problems, monitoring migraines are crucial. In fact, research shows that one in 10 people suffers from headaches (Elrington, 2002). In the US and Western Europe, in particular, 5-12% of the population experience migraine attacks on a regular basis. Although there are various mHealth apps, printed diaries, and medical calendars to track headaches, migraines are often underestimated. Consequently, patients avoid professional help as practitioners undervalue their symptoms and disability.

Therefore, mHealth apps are becoming more and more popular among patients. Interestingly, a systematic review conducted by Stubberud and colleagues revealed that in 2017, 325,000 mHealth apps were identified on the market. In addition, 50% of the world’s 3.4 billion users reported downloading a mHealth app (Stubberud & Linde, 2018). Note that there are more than three thousand apps related to migraine symptoms, which are the third most searched apps worldwide. With the increasing advancements in digital health, it’s not surprising that these numbers are increasing. Computer- and smartphone-based solutions can help patients and experts get a better understanding of migraine attacks and their impact on societies, including:

  • Pathophysiology and screening: Understanding the pathophysiological processes behind headaches is an essential step towards better practices. In fact, research shows that spontaneous overactivity in the brainstem leads to a migraine (Erlington, 2002). Full neurological examination, including magnetic resonance imaging, should be performed, as well as screening for co-morbid diseases. Note that blood tests can help doctors identify brain and spinal infections, and brain scans can help experts diagnose stroke and tumors.
  • Overall health and emotional well-being: Migraine is a complex neurological condition. Migraines are often accompanied by nausea, sensitivity to noises, gastrointestinal problems, etc. As a result, health problems can become an emotional and financial burden on patients and societies. Therefore, along with lab tests, professionals should shift perspectives and focus on patients’ well-being.
  • Diagnosis and classifications: An accurate diagnosis of headache attacks can only benefit treatment. We should mention that there are different types of headaches, including migraines. Common types are tension-type headaches, cluster headaches (the most severe headaches), and medication overuse headaches. Classifying migraines, in particular, is crucial. Migraines are divided into migraines with aura and migraines without aura. Note that most aura is visual and consists of symptoms, such as floaters and flashes of light. There are also negative phenomena, including loss of vision. Another common type of aura is sensory (e.g., tingling sensations over the face and body) (Weatherall, 2015).
  • History, triggers, and patterns: An in-depth investigation of a patient’s history can benefit diagnosis and treatment. As explained above, establishing pain duration, periods, and frequency is vital, so all behavioral changes should be monitored. Patterns and triggers, such as international travels or menstruation in women, should be documented as well. Note that menstruation is a trigger in 10% of female patients. Post-traumatic migraines and post-traumatic migraine require additional investigation and support.
  • Drug use and effectiveness: Although migraines cannot be cured, they can be managed successfully. Note that overuse of acute medication can lead to chronic headaches. Opiates, in particular, can worsen gastrointestinal problems and lead to addiction. Alternative types of treatment (e.g., rest, yoga, massage therapy) should be considered.
  • Health outcomes: When assessing migraine attacks, all health and socioeconomic changes (before and after treatment) need to be considered. We should mention that migraine attacks in children need special consideration; management should address diet and lifestyle, instead of acute pain medication. Note that, as explained above, a profound assessment of a patients’ quality of life is essential to improve treatment and health outcomes.

Digital Migraine Journals: Benefits and Perspectives

Digital solutions are shaping the future of medicine. Of all tech solutions, migraine journals are the most prominent tools, with numerous advantages and perspectives. Since some patients suffer from intractable migraines, reassessing and tracking pain symptoms is crucial. Keeping a diary can help patients enter vital information in real time, avoiding backfilling. In fact, a study conducted by Baos and colleagues showed that patients who were satisfied with keeping a migraine diary were more content with the medical care they received (Baos et al., 2005). That’s not surprising as physicians reported that a structured migraine journal helped them improve doctor-patient communication and understand aspects, such as pain severity, disability, medication, and symptoms (e.g., photophobia).

Digital migraine diaries are the key to migraine treatment. With proper usability, attractive designs, and customized options, digital journals have numerous advantages over standard and paper methods. In addition, the optimization of migraine apps (e.g., interface) has the potential to engage specific populations, such as children and young adults. What’s more, digital solutions can help patients take an active role in the monitoring and management of their condition (Mosadeghi-Nik et al., 2016). Note that along with mHealth solutions, electronic behavioral interventions and telemedicine consultation can also be used to treat headaches (Stubberud & Linde, 2018).

Migraine Journals: Clear Your Head with Qolty

By keeping a migraine journal patients and professionals can get a better understanding of migraine attacks and improve medical outcomes. What’s more, since many people rely on mHealth solutions, migraine diaries have become an effective, non-invasive, and engaging approach to migraines. Tech approaches provide tailored and customized solutions. For instance, patients can control the brightness of their devices, which can be beneficial for patients sensitive to light. Digital migraine journals can be used across multiple settings. They can be beneficial to:

  • Track and study migraine attacks: As mentioned above, migraine journals can reveal hidden patterns and vital aspects of migraine attacks. In addition, journals can reveal seasonal patterns. Note that some apps can synchronize with the weather and help patients and doctors explore the phenomenon in detail.
  • Send accurate data in real time: Research shows that perceived triggers of migraine can be inaccurate. Therefore, a headache journal can help patients enter data in real time and discover which factors trigger headaches. Note that apps integrate sophisticated analyses to explore aspects, such as sleep, food, and menstruation.
  • Lead to real action steps: Since patients report that doctors often underestimate their headaches, a migraine journal can be detailed proof of pain severity and patterns. Apps can send data in real time, which will make visits and check-ups more productive. Detailed information can improve health outcomes, especially in patients who experience acute attacks and require Emergency Room treatment.
  • Show treatment effectiveness: By leading a migraine journal, both doctors and patients can assess the effectiveness of an intervention and manage treatment. Note that one of the main factors in research and practice is a patient’s quality of life.
  • Help insurance claims: Migraine diaries can prove the severity, frequency, and duration of a patient’s migraine attacks, which can support their insurance claims.

An accurate diagnosis achieved by a migraine journal can lead to better treatment. A migraine journal is essential in both treatment and evaluation. Note that when it comes to migraines, the pharmacological treatment of migraine attacks is usually divided into abortive and preventive (Silberstein, 2009). As migraine attacks can last between four and 72 hours, with 15% of patients experiencing migraine with aura (of up to one hour), treatment should be tailored to each patient. There are numerous pain relievers on the market. From aspirin to acetaminophen, patients must understand that prolonged use can lead to ulcers and medication overuse headaches. Note that triptans and ergots (in combination with caffeine) are also very popular. Patients often need anti-nausea medication in combination with pain relievers. At the same time, preventive medication is more effective in severe migraines. Preventive treatment can result in better patient outcomes and healthcare cost reductions. Such treatment includes cardiovascular drugs, antidepressants (even in people without depression), anti-seizure drugs, supplements, and acupuncture. Alternative practices involve massage therapy and cognitive behavioral therapy.

Migraine Journals: Conclusion

Migraine journals are essential in the evaluation of migraine attacks and treatments. They can help patients track various symptoms, patterns, and triggers, and establish a better doctor-patient relationship with their provider. As a result, doctors can assess a patient’s individual needs and opt for better interventions and pain management.

Digital migraine journals, in particular, can result in better communication and health outcomes. Migraine apps and online platforms are increasing in popularity, with numerous clinical trials and studies revealing their effectiveness. Digital health is changing the future of migraine treatments and patient outcomes, with Qolty being the key to a pain-free life.

References

Baos, V., Ester, F., Castellanos, A., Nocea, G., Caloto, M., & Gerth, W. (2005). Use of a structured migraine diary improves patient and physician communication about migraine disability and treatment outcomes.  International Journal of Clinical Practice, 59 (3).

Elrington, G. (2002). Migraine: Diagnosis and management. Journal of Neurology, Neurosurgery and Psychiatry, 72 (2).

Mosadeghi-Nik, M., Askari, M., & Fatehi, F. (2016). Mobile health (mHealth) for headache disorders: A review of the evidence base. Journal of Telemedicine and Telecare, 22 (8).

Silberstein, S. (2009). Preventive migraine treatment. Neurologic Clinics, 27 (2).

Stubberud, A., & Linde M. (2018). Digital Technology and Mobile Health in Behavioral Migraine Therapy: A Narrative Review. Current Pain and Headache Reports, 22(10).

Weatherall, M. (2015). The diagnosis and treatment of chronic migraine. Therapeutic Advances in Chronic Disease, 6 (3).